Presenting author biography:

Braden is a communications and Liaison officer at the Kenya Sex Workers Alliance , who is passionate about sex work issues and has worked with sex workers using drugs which has capacity built him. Hes queer and believes in equality of sexes.

Access to harm reduction programs among sex workers who inject drugs: findings from a respondent-driven sampling survey in Nairobi,Kenya.

Braden Njukia

Over the past two decades, drug injection-related risk behaviors have been the major drivers of the HIV epidemic in Kenya. This study assesses the access of sex workers who injected drugs (SWID) to harm reduction services (needle-exchange programs [NEP] and methadone maintenance treatment [MMT]) in Nairobi, Kenya in 2016, almost a year after the large-scale implementation of these programs.
METHODS:
572 consenting SWID (>18 years old, ever injected in the past month, lived in Nairobi) were recruited (24 seeds) into a sero-behavioral survey using respondent-driven sampling method. Participants completed a face-to-face interview about HIV-related risk behaviors and access to harm reduction services. We calculated adjusted population estimates using RDSAT.
RESULTS:
Overall, 99.2% of the participants were female and male sex workers, 41.6% aged between 30 and 39 years old, 55.4% lived alone in the past year, 83.2% were ever incarcerated, and 88.8% lived in the outskirts of Nairobi. In terms of "awareness" and "use" of services among SWID, 62.8% and 54.8% reported for NEP (respectively) and 19.7% and 9.1% for drug treatment services (respectively) . Similarly, SWID who lived with friends were more likely to be aware of (88.6%) and use (85.9%) services (vs. other living partners). Overall, 11% of the participants were aware of but had not used any harm reduction services.
CONCLUSIONS:
Despite a relatively high level of access to NEP among SWID in Nairobi, a sizable fraction of the population remains without access to other services almost two years after their implementation. The use of harm reduction may be affected by certain SWID characteristics (e.g., living partners and geographical location). Ongoing surveillance activities are necessary to track change in access over time.